Table 2 Elements of health screening web sections, guide questions and the related ethical concepts

Clinical appropriateness of screening tests in HSPs

How many tests are offered?

What types of tests are offered (i.e. investigation modality)?

What conditions are being screened?

Are non-recommended tests being offered? (Referenced with the 2019 Screening Test Review Committee report.)

Appropriateness of tests, and their potential risks and benefits, which is relevant to issues of beneficence and non-maleficence

How HSPs are conducted (i.e. the process of a HSP)

Is there medical consultation before package selection?

Is there a medical assessment included in the HSP?

Is there a post-screening review with a doctor?

Were patients sufficiently appraised of the benefits, risks and alternatives of the tests (i.e. informed consent, beneficence and non-maleficence)?

Price range and composition of HSPs

How much do HSPs cost?

How many HSPs does each provider offer?

How do tests in the cheapest package compare with the ‘Screen for Life’ national programme?

How do tests in the cheapest package compare between providers?

Is there a fair allocation of healthcare resources that is effective in promoting individual and societal welfare (i.e. justice and beneficence)?

Messages communicated by HSP providers on main page of health screening section

What are the key themes of messages communicated by HSP providers’ websites?

Do the websites provide factual information about screening?

Do they give a balanced view on screening (including potential harms such as false positives, overdiagnosis and overtreatment)?

Do the websites create undue anxiety or unrealistic expectations (i.e. informed consent, beneficence and non-maleficence)?